Breast Fat Transfer

You’d like to go up by about one to one and a half cup sizes, and you’d rather not have implants because of scarring or an unnatural shape or feel.

It may also suit you if, after implant surgery, the implant shows through thin skin or you have rippling; if you carry more weight in your lower body but are slim on top; if you’d like to keep the breast size you had before losing weight; or if you’d like larger breasts without others being able to tell you’ve had surgery.

You’d like to go up by three or more cup sizes, you don’t have enough fat to harvest, you’ve had filler of unknown composition injected into your breasts in the past, or your breasts sag significantly.

We take photos, then talk through the result you’d like while assessing your skin, the size of your breast (glandular) tissue and the thickness of the fat under your skin. This takes about 10 minutes.

The surgery is done under IV sedation. Harvesting and processing the fat takes about 1 hour, and transferring it to the breasts takes about another hour.

Most people feel very little pain in the breasts. The areas where fat was harvested may ache, like sore muscles, for 1–2 weeks.

You can return to daily activities the next day, but please avoid alcohol and smoking for at least a month. Transferred fat is sensitive to pressure, so for at least a month, please also avoid anything that presses on your breasts, such as tight clothing or sleeping on your stomach.

Right after surgery, your breasts look about two cup sizes larger because of swelling and the amount of fat added. Most of the swelling goes down in the first 2 weeks. Over the next 2 weeks, fat that didn’t take is absorbed and the size gradually decreases. Over the first month, the volume decreases by about 30–40%. At 3 months, about 50% of the transferred fat usually remains.

Body weight matters most for how much fat stays. Please keep your weight where it was at the time of surgery, and try not to lose weight. Published studies show that when weight stays stable, the fat that has taken also stays.

If you’d like a second procedure, we recommend waiting at least 3–6 months.

Many people worry about calcification or oil cysts. These are indeed the typical complications of fat transfer, and the risk goes up when too much fat is added. But not every fat transfer leads to oil cysts or calcification, especially when an appropriate amount is added within a range that doesn’t raise the risk.

Published studies report a rate of about 5%, but that figure includes small findings seen only on ultrasound, so cases that actually cause problems are rarer. Dr. Oh doesn’t simply add as much as possible. He calculates the amount needed based on how much space the breast has. In his experience, these complications have occurred in about 2 in 1,000 patients.

Many people also ask whether fat transfer can lift sagging breasts. If the breasts themselves sag a lot, fat transfer alone can’t lift them much, so we suggest considering a breast lift as well. If the sagging is mild and the breasts have simply lost volume with weight loss, fat transfer can improve the shape.

When people ask whether others will be able to tell, our answer is that it’s hard to tell. A breast is made up of breast tissue and fat, and fat transfer adds to the fat, so it feels the same as a natural breast. The incision is made in the armpit, around the areola or in the fold under the breast. It is very small, so the scar is hard to see once it heals.